Impact of dynamic balance and hip abductor strength on chronic ankle instability

  1. López-Valenciano, Alejandro 1
  2. Ayala Rodríguez, Francisco
  3. López-Elvira, José Luis
  4. Barbado Murillo, David
  5. Vera-García, Francisco José
  1. 1 Universidad Miguel Hernández de Elche
    info

    Universidad Miguel Hernández de Elche

    Elche, España

    ROR https://ror.org/01azzms13

Revista:
European Journal of Human Movement

ISSN: 0214-0071 2386-4095

Año de publicación: 2016

Número: 36

Páginas: 137-149

Tipo: Artículo

Otras publicaciones en: European Journal of Human Movement

Resumen

Introducción: Los esguinces de tobillo son lesiones comunes durante la actividad física. Constituyen entre el 15-75% de todas las lesiones deportivas, pudiendo degenerar en una inestabilidad crónica de tobillo (ICT) e incapacidad funcional. Los sujetos con ICT han mostrado un equilibrio dinámico disminuido y debilidad en los músculos abductores de la cadera. Por lo tanto, el objetivo de este estudio fue investigar si el equilibrio dinámico y la fuerza de abducción de la cadera estaban relacionadas con el nivel de gravedad de la ICT. Material y Método: 40 estudiantes con ICT, definida por el cuestionario Cumberland ankle instability (CAIT), se dividieron en dos grupos: inestabilidad grave e inestabilidad leve. Resultados: No se encontraron correlaciones significativas entre las variables del CAIT, Y-Balance y fuerza en ningún grupo. El Y-Balance explicó el 24,7% de la varianza de ICT en el análisis de regresión, siendo estadísticamente significativo en el modelo predictivo (p <0,01). Discusión: Este estudio refuerza la necesidad de incluir ejercicios de equilibrio para las extremidades inferiores como un factor clave en el diseño de programas de rehabilitación para los deportistas con ICT, no así los ejercicios de fuerza de abductores de cadera. Este conocimiento permitiría a los terapeutas deportivos diseñar programas de rehabilitación más eficaces.

Referencias bibliográficas

  • Ambegaonkar, J.P., Mettinger, L.M., Caswell, S.V., Burtt, A., & Cortes, N. (2014). Relationships between core endurance, hip strength, and balance in collegiate female athletes. Int J Sports Phys Ther, 9(5), 604-616.
  • Bosien, W.R., Staples, O.S., & Russell, S.W. (1955). Residual disability following acute ankle sprains. J Bone Joint Surg Am, 37, 1237–1243.
  • Boyle, J., & Negus, V. (1998). Joint position sense in the recurrently sprained ankle. Aust J Physiother, 44, 159–63.
  • Bullocksaxton, J.E., Janda, V., Bullock, M. (1994). The influence of ankle sprain injury on muscle activation during hip extension. International Journal of Sports Medicine, 15(6), 330-334.
  • Clanton, T.O. (1989). Instability of the subtalar joint. Orthop Clin North Am, 20, 583–592.
  • De Noronha, M., Refshauge, K.M., Crosbie, J., & Kilbreath, S.L. (2008). Relationship between functional ankle instability and postural control. Journal of orthopaedic & sports physical therapy, 38(12), 782-789.
  • De Noronha, M.D., Franca, L.C., Haupenthal, A., & Nunes, G.S. (2013). Intrinsic predictive factors for ankle sprain in active university students: a prospective study. Scandinavian journal of medicine & science in sports, 23(5), 541-547.
  • De Noronha, M., Refshauge, K.M., & Kilbreath, S.L., & Crosbie J. (2007). Loss of proprioception or motor control is not related to functional ankle instability: an observational study. Aust J Physiother, 53, 193–8.
  • Delahunt, E., Coughlan, G.F., Caulfield, B., Nightingale, E. J., Lin, C.W. & Hiller, C.E. (2010). Inclusion criteria when investigating insufficiencies in chronic ankle instability. Medicine and Science in Sports and Exercise, 42(11), 2106-2121.
  • Fernandez, W.G., Yard, E.E. & Comstock, R.D. (2007). Epidemiology of lower extremity injuries among U.S. high school athletes. Acad Emerg Med, 14(7), 641-5.
  • Filipa, A., Byrnes, R., Paterno, M.V., Myer, G.D., & Hewett, T.E. (2010). Neuromuscular training improves performance on the Star Excursion Balance Test in young female athletes. J Orthop Sports Phys Ther, 40(9), 551–558.
  • Fong, D.T.P., Hong, Y., Chan, L.K., Yung, P.S.H., & Chan, K.M. (2007). A systematic review on ankle injury and ankle sprain in sports. Sports medicine, 37(1), 73-94.
  • Fousekis, K., Tsepis, E., & Vagenas, G. (2012). Intrinsic risk factors of noncontact ankle sprains in soccer a prospective study on 100 professional players. The American journal of sports medicine, 40(8), 1842-1850.
  • Friel, K., McLean, N., Myers, C., & Caceres, M. (2006). Ipsilateral hip abductor weakness after inversion ankle sprain. J Athl Train, 41, 74-8.
  • Gauffin, H. (1991). Knee and ankle kinesiology and joint instability [dissertation]. Linkoping University: Linkoping.
  • Gribble, P.A., Hertel, J., & Denegar, C.R. (2007). Chronic ankle instability and fatigue create proximal joint alterations during performance of the Star Excursion Balance Test. Int J Sports Med, 28(3), 236-42.
  • Gribble, PA., Hertel, J., & Plisky, P. (2012) Using the Star Excursion Balance Test to assess dynamic postural-control deficits and outcomes in lower extremity injury: a literature and systematic review. Journal of Athletic Training, 47, 339-357.
  • Gribble, P.A., & Robinson, R.H. (2009). An examination of ankle, knee, and hip torque production in individuals with chronic ankle instability. J Strength Cond Res, 23, 395.
  • Gross, M.T. (1987). Effects of recurrent lateral ankle sprains on active and passive judgements of joint position. Phys Ther, 67, 1505-1509.
  • Hertel J. (2002). Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train, 37, 364–375.
  • Hertel, J., Braham, R.A., Hale, S.A., & Olmsted-Kramer, L.C. (2006). Simplifying the Star Excursion Balance Test: analyses of subjects with and without chronic ankle instability. J Orthop Sports Phys Ther, 36(3), 131–137.
  • Hiller, C.E., Refshauge, K.M., Bundy, A.C., Herbert, R.D., & Kilbreath, S.L. (2006). The Cumberland ankle instability tool: a report of validity and reliability testing. Arch Phys Med Rehabil, 87, 1235-41.
  • Hiller, C.E., Refshauge, K.M., Herbert, R.D, & Kilbreath, S.L. (2007). Balance and recovery from a perturbation are impaired in people with functional ankle instability. Clin J Sport Med, 17, 269–75.
  • Hootman, J.M., Dick R., & Agel, J. (2007). Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. J Athl Train, 42(2), 311-9.
  • Hubbard, T.J., & Hertel, J. (2006). Mechanical contributions to chronic ankle instability. Sports Med, 36, 263–277
  • Hubbard, T.J., Kramer, L.C., Denegar, C.R., & Hertel, J. (2007a). Correlations among multiple measures of functional and mechanical instability in subjects with chronic ankle instability. Journal of Athletic Training. 42(3), 361-366.
  • Hubbard, T.J., Kramer, L.C., Denegar, C.R., & Hertel J. (2007b). Contributing factors to chronic ankle instability. Foot Ankle Int, 28(3), 343–354.
  • Karlsson, J., Bergsten, T., Peterson, L., & Zachrisson, B.E. (1991). Radiographic evaluation of ankle joint stability. Clin J Sport Med, 1, 166–175.
  • Kumar-Jain, T. (2014). Objective evaluation of functional ankle instability and balance exercise treatment (Doctoral thesis, University of Kansas, EE.UU.). Retrieved from https://kuscholarworks.ku.edu/handle/1808/15772
  • Larsen, E., & Angermann, P. (1990). Association of ankle instability and foot deformity. Acta Orthop Scand, 61, 136–139.
  • Lentell, G.B., Baas, B., Lopez, D., McGuire, L., Sarrels, M., & Synder, P. (1995). The contributions of proprioceptive deficits, muscle function, and anatomic laxity to functional instability of the ankle. J Orthop Sports Phys Ther, 21, 206–215.
  • McHugh, M.P., Tyler, T.F., Tetro, D.T., Mullaney, M.J., & Nicholas, S.J. (2006). Risk factors for noncontact ankle sprains in high school athletes -The role of hip strength and balance ability. American Journal of Sports Medicine, 34(3), 464-470.
  • McKeon, P.O., & Hertel, J. (2008). Systematic review of postural control and lateral ankle instability, part I: can deficits be detected with instrumented testing?. Journal of athletic training, 43(3), 293-304.
  • Mulloy Forkin, D.M., Koczur, C., Battle, R., & Newton, R.A. (1996). Evaluation of kinesthetic deficits indicative of balance control in gymnasts with unilateral chronic ankle sprains. J Orthop Sports Phys Ther, 23, 245–50.
  • Nakasa, T., Fukuhara, K., Adachi, N., & Ochi, M. (2008). The deficit of joint position sense in the chronic unstable ankle as measured by inversion angle replication error. Arch Orthop Trauma Surg,128, 445–9.
  • Negahban, H., Moradi-Bousari, A., Naghibi, S., Sarrafzadez, J., Shaterzadeh-Yazdil, M., Goharpey, S. et al. (2013). The eccentric torque production capacity of the ankle, knee, and hip muscle groups in patients with unilateral chronic ankle instability. Asian J Sports Med, 4, 144–152.
  • Nicholas, J.A., Strizak, A.M., & Veras, G. (1976). A study of thigh muscle weakness in different pathological states of the lower extremity. Am J Sports Med, 4, 241–248
  • Olmsted, L.C, Carcia, C.R., Hertel, J., & Shultz, S.J. (2002): Efficacy of the star excursion balance tests in detecting reach deficits in subjects with chronic ankle instability. J Athl Train, 37(4), 501–6.
  • Pisani, G., Pisani, P.C., & Parino, E. (2005). Sinus tarsi syndrome and subtalar joint instability. Clin Podiatr Med Surg, 22(1), 63-77, vii.
  • Plisky, P.J., Rauh, M.J., Kaminski, T.W., & Underwood, F.B. (2006). Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players. J Orthop Sports Phys Ther, 36(12), 911-919.
  • Read, P.J., Oliver, J.L., De Ste Croix, M.B., Myer, G.D., & Lloyd, R.S. (2016). Neuromuscular Risk Factors for Knee and Ankle Ligament Injuries in Male Youth Soccer Players. Sports Med.
  • Ross, S.E., & Guskiewicz, K.M. (2004). Examination of static and dynamic postural stability in individuals with functionally stable and unstable ankles. Clinical Journal of Sport Medicine, 14(6), 332-338.
  • Santos, M.J., & Liu, W. (2008). Possible factors related to functional ankle instability. J Orthop Sports Phys Ther, 38(3), 150-7.
  • Shaffer, S.W., Teyhen, D.S., Lorenson, C.L., Warren, R.L., Koreerat, C.M., Straseske, C.A., & Childs, J.D. (2013). Y-balance test: A reliability study involving multiple raters. Military Medicine, 178(11), 1264-1270.
  • Staples, O.S. (1975). Ruptures of the fibular collateral ligaments of the ankle: result study of immediate surgical treatment. J Bone Joint Surg Am, 57, 101–107.
  • Tol, J.L., Struijs, P.A.A., Bossuyt, P.M.M., Verhagen, R.A.W., & Van Dijk, C. N. (2000). Treatment strategies in osteochondral defects of the talar dome: a systematic review. Foot & Ankle International, 21(2), 119-126.
  • Thorborg, K., Petersen, J., Magnusson, S.P., & Hölmich, P. (2010). Clinical assessment of hip strength using a hand-held dynamometer is reliable. Scand J Med Sci Sports, 20, 493–501. doi: 10.1111/j.1600-0838.2009.00958.x
  • Valderrabano, V., Hintermann, B., Horisberger, M., & Fung, T.S. (2006). Ligamentous posttraumatic ankle osteoarthritis. The American journal of sports medicine, 34(4), 612-620.
  • Verhagen, R.A., de Keizer, G., & van Dijk, C.N. (1995). Long-term follow-up of inversion trauma of the ankle. Arch Orthop Trauma Surg, 114(2), 92-96.
  • Wikstrom, E.A., Tillman, M.D., & Borsa, P.A. (2005). Detection of dynamic stability deficits in subjects with functional ankle instability. Med Sci Sports Ex erc, 37, 169-175.